Apply to Join | KEN-YA YOGA? | Adventure Out Loud

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Select a date

Yoga experience

Gender*

Personal details (as per passport)*

First Name

Last*

Last Name

Preferred*

Nickname

Passport number*

Passport number

Nationality*

Nationality

Place of birth*

Place of birth

Issue date*

Issue date (dd/mm/yyyy)

Expiry date*

Expiry date (dd/mm/yyyy)

Date of birth*

Date of birth (dd/mm/yyyy)

Phone*

Phone

Email*

Address*

Street

Suburb*

Suburb

State*

State

Country*

Country

Postcode*

Postcode

Tell us about you*

We use this info to make sure this is the right adventure for you. If your application is successful, we also use the information to introduce you to the rest of the tour group. Things you could include: what you do, things you are passionate about, what you are most excited for during the tour, something interesting/unique about you, etc.

Allergies, medical conditions or special requirements*

Please advise us if you would like us to call you to discuss.

Emergency Contact*

First Name

Emergency Contact*

Last Name

Phone*

Phone

Email*

Discount code

Please enter your discount code if you have one

Shirt size*

Complimentary yoga or travel shirt.

How did you hear about us*

Flights*

Travel insurance*

I want to add:

Single supplement (yoga & safari): $600 - $1,000pp

Gorilla trekking (5 days): $4,499pp

Single supplement (Gorillas): $700pp

Mt Kilimanjaro (10 days): $4,499pp

Massage therapist (safari): $300pp

Adventure memories travel book: $150pp

Sponsor a disadvantaged student through school*

Yes

Sponsorship is not mandatory but it is recommended. Not only will you be empowering a young Kenyan student by keeping them in school, you will also be enhancing your travel experience and making a huge impact in the communities you'll be travelling to. Sponsorship is AUD$1,000/year or AUD$20/week and 100% goes to our partner charity. Fundraising is also a great option.

Payment options*

Deposit only

Full fee

Pay adventure off in weekly/monthly installments

Upon receipt of your registration form, we will send you an invoice that includes payment options and directions for payment. Minimum deposit is 10% of total fee.

I acknowledge that the information supplied on this registration form was supplied by me, is true and accurate and if under 18 years was provided in the presence of and with the approval of my parent/guardian. By paying my adventure deposit, I acknowledge that I have read Adventure Out Loud's Terms & Conditions and that I agree to be bound by these terms and conditions.*

Agree

Disagree (please contact me to discuss)

Our Terms & Conditions can be found below.

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Apply to join Ken-ya Yoga? | A yoga and safari adventure

Terms & Conditions

Mandatory Medical Form

THE MIGRATING YOGI

KEN-YA YOGA?

SAFARI NINJA

LUXURY SAFARI